Archives of Internal Medicine. Annals of Family Medicine. American Journal of Managed Care. Support Center Support Center. External link. Please review our privacy policy. Use computerized provider order entry CPOE for medication orders directly entered by any licensed health care professional who can enter orders into the medical record per state, local, and professional guidelines.
The number of patients in the denominator that have at least one medication order entered using CPOE. Number of unique patients with at least one medication in their medication list seen by the EP during the EHR reporting period. Any EP who writes fewer than prescriptions during the EHR reporting period would be excluded from this requirement. Maintain an up-to-date problem list of current and active diagnoses. Number of patients in the denominator who have at least one entry or an indication that no problems are known for the patient recorded as structured data in their problem list.
Generate and transmit permissible prescriptions electronically eRx. Number of prescriptions in the denominator generated and transmitted electronically. Number of prescriptions written for drugs requiring a prescription to be dispensed other than controlled substances during the EHR reporting period.
Number of patients in the denominator who have a medication or an indication that the patient is not currently prescribed any medication recorded as structured data. Number of unique patients in the denominator who have at least one entry or an indication that the patient has no known medication allergies recorded as structured data in their medication allergy list.
Record all of the following demographics: preferred language, gender, race, ethnicity, date of birth. Number of patients in the denominator who have all the elements of demographics or a specific exclusion if the patient declined to provide one or more elements or if recording an element is contrary with state law recorded as structured data. Number of patients in the denominator who have at least one entry of their height, weight, and blood pressure are recorded as structured data.
An EP who believes all three vital signs of height, weight, and blood pressure have no relevance to their scope of practice. Number of patients in the denominator with smoking status recorded as structured data. Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule. Provide patients with an electronic copy of their health information including diagnostic test results, problem list, medication lists, medication allergies , upon request.
Number of patients in the denominator who receive an electronic copy of their electronic health information within three business days. Number of patients of the EP who request an electronic copy of their electronic health information four business days prior to the end of the EHR reporting period.
An EP who has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period would be excluded from this requirement.
Provide clinical summaries for patients for each office visit. Number of office visits in the denominator for which a clinical summary of the visit is provided within three business days.
Any EP who has no office visits during the EHR reporting period would be excluded from this requirement. Capability to exchange key clinical information for example, problem list, medication list, allergies, diagnostic test results , among providers of care and patient authorized entities electronically.
Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
Any EP who writes fewer than prescriptions during the EHR reporting period can be excluded from this requirement. Incorporate clinical lab-test results into EHR as structured data. Number of lab test results whose results are expressed in a positive or negative affirmation or as a number which are incorporated as structured data.
Number of lab tests ordered during the EHR reporting period by the EP whose results are expressed in a positive or negative affirmation or as a number. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach. Number of patients in the denominator who were sent the appropriate reminder. Provide patients with timely electronic access to their health information including lab results, problem list, medication lists, and allergies within four business days of the information being available to the EP.
Number of patients in the denominator who have timely available to the patient within four business days of being updated in the certified EHR technology electronic access to their health information online.
Any EP who neither orders nor creates lab tests or information that would be contained in the problem list, medication list, or medication allergy list during the EHR reporting period would be excluded from this requirement. Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate. Number of patients in the denominator who are provided patient-specific education resources. The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.
Number of transitions of care in the denominator where medication reconciliation was performed. Number of transitions of care during the EHR reporting period for which the EP was the receiving party of the transition. An EP who was not on the receiving end of any transition of care during the EHR reporting period would be excluded from this requirement.
The EP who transitions a patient to another setting of care or provider of care or refers a patient to another provider of care should provide summary of care record for each transition of care or referral. Number of transitions of care and referrals in the denominator where a summary of care record was provided. Number of transitions of care and referrals during the EHR reporting period for which the EP was the transferring or referring provider. An EP who does not transfer a patient to another setting or refer a patient to another provider during the EHR reporting period would be excluded from this requirement.
Capability to submit electronic data to immunization registries or immunization information systems and actual submission in accordance with applicable law and practice. An EP who does not perform immunizations during the EHR reporting period would be excluded from this requirement If there is no immunization registry that has the capacity to receive the information electronically, an EP would be excluded from this requirement.
Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice. This measure may, therefore, underestimate the percentage of eligible phyician assistants participating in the Incentive Programs. The POS file includes data on all non-ambulatory and some ambulatory care settings registered to participate in the Medicare and Medicaid fee-for-service programs.
POS data includes registration, accreditation, and certification information about each facility. The POS data is analyzed to determine if hospitals are currently active. A hospital may be inactive because it is closed, has consolidated reporting with another hospital, or has been decertified by CMS and thus not eligible to participate in the fee-for-service or Incentive Programs. Any hospital deemed inactive is removed from the denominator count to make the most precise estimation of eligible hospitals at the state level.
Any hospital deemed inactive is also excluded from the numerator to approximate the most accurate measure of active, eligible hospitals participating in the Incentive Programs. Small hospitals have fewer than inpatient beds. Rural hospitals are located in non-metropolitan areas.
Content last reviewed on August 4, Was this page helpful? Therefore, if a hospital is an eligible hospital, as defined in the Medicare EHR Incentive Program, and receives Medicare payments, the organization may be subject to payment reduction if it does not become a meaningful user of certified EHR.
If a hospital attests that it is a meaningful user of certified EHR and the representation is false and the hospital accepts federal funds under Medicare and Medicaid EHR Incentive Programs, the organization has potentially submitted a false claim or representation that may be actionable under the False Claims Act or other federal statutes.
In coming years, the federal government will be allocating a substantial amount of funding to promote the adoption and meaningful use of certified EHR. Thus, participants in the programs must ensure that they comply with all applicable regulations. The following list outlines tips that COs should consider:. COs should play a key role in the oversight of this collaboration. COs may wish to consult and work with the chief financial officer, information technology staff, privacy and security officials, legal, internal audits, business associates, and health care professionals to monitor compliance with the Medicare and Medicaid EHR Incentive Programs.
An additional compliance risk may be with hospital-based physicians. For example, one of the required meaningful use objectives is to use computerized provider order entry CPOE for medication orders that are directly entered by a licensed health care professional. COs must be aware that in order to meet this objective, a licensed health care professional must be the individual who enters the information. Therefore, COs should consider conducting compliance training on this requirement to appropriate staff in order to ensure that the objective is fully met.
COs also need to be aware of the requirements concerning the certification of EHR technology. To receive incentive payments, providers must use certified EHR.
COs should consider develop their own auditing and monitoring strategy in assessing risks of non-compliance. For proper implementation of EHR technology, it will be necessary for hospitals to stay informed about HHS implementation activities. See Appendix 4. COs can play a significant role in notifying their organization of the program rules and deadlines, as well as ensuring that the requirements are fully met.
Hospitals must report the following 15 clinical quality measures under the Medicare and Medicaid EHR incentive program:. Health Affairs. Accessed on 8 Sept. For permission to reprint, e-mail permissions cch. We respect your privacy and will never share any of your personal information with third parties. Facebook 0 Tweet 0 LinkedIn 0. This site uses cookies and other tracking technologies to assist with navigation and your ability to provide feedback, analyze your use of our products and services, assist with our promotional and marketing efforts, and provide content from third parties.
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